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Rheumatoid lung disease

Definition

Rheumatoid lung disease is a group of lung problems related to rheumatoid arthritis. The condition can include:

Alternative Names

Lung disease - rheumatoid arthritis; Rheumatoid nodules; Rheumatoid lung

Causes

Lung problems are common in rheumatoid arthritis. They often cause no symptoms.

The cause of lung disease associated with rheumatoid arthritis is unknown. Sometimes, the medicines used to treat rheumatoid arthritis, especially methotrexate, may result in lung disease.

Symptoms

Symptoms may include any of the following:

Exams and Tests

The health care provider will perform a physical examination and ask about your symptoms.

Symptoms depend on the type of lung disease rheumatoid arthritis is causing in the lungs.

The provider may hear crackles (rales) when listening to the lungs with a stethoscope. Or, there may be decreased breath sounds, wheezing, a rubbing sound, or normal breath sounds. When listening to the heart, there may be abnormal heart sounds.

The following tests may show signs of rheumatoid lung disease:

Treatment

Many people with this condition have no symptoms. Treatment is aimed at the health problems causing the lung problem and the complications caused by the disorder. Corticosteroids or other medicines that suppress the immune system are sometimes useful.

There is no evidence that pirfenidone or nintedanib work for people with rheumatoid lung disease and fibrosis (like they do for the idiopathic form of the disease).

Outlook (Prognosis)

Outcome is related to the underlying disorder and the type and severity of lung disease. In severe cases, lung transplantation can be considered. This is more common in cases of bronchiolitis obliterans, pulmonary fibrosis, or pulmonary hypertension.

Possible Complications

Rheumatoid lung disease may lead to:

When to Contact a Medical Professional

Call your provider right away if you have rheumatoid arthritis and you develop unexplained breathing difficulties.

Gallery

Bronchoscopy
Bronchoscopy is a surgical technique for viewing the interior of the airways. Using sophisticated flexible fiber optic instruments, surgeons are able to explore the trachea, main stem bronchi, and some of the small bronchi. In children, this procedure may be used to remove foreign objects that have been inhaled. In adults, the procedure is most often used to take samples of (biopsy) suspicious lesions and for culturing specific areas in the lung.
Coronavirus
Coronaviruses are a family of viruses. Infection with these viruses can cause mild to moderate respiratory illnesses such as the common cold. Some coronaviruses may cause severe illness and lead to pneumonia or even death.

References

Corte TJ, Wells AU. Connective tissue diseases. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 92.

Yunt ZX, Solomon JJ. Lung disease in rheumatoid arthritis. Rheum Dis Clin North Am. 2015;41(2):225-236. PMID: PMC4415514 www.ncbi.nlm.nih.gov/pmc/articles/PMC4415514/.

Last reviewed May 30, 2021 by Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team..

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